Newbie at work need your help, please!!!

caliotter3 · May 6, 2010

Every one of these questions can be answered by your charge nurse and you should direct your questions to her/him since they know the routine at your facility. Let the nurse know that the CNA orienting you did not provide all this info. If you don't want to bother the nurse too often, then ask the person who oriented you. They should have told you all of this within the first couple of shifts that you worked. Make sure you take a little notebook and a pen with you so you can write this stuff down.

caliotter3 · May 6, 2010

If you are talking about night shift especially, oral care is often never done in facilities. CNAs either don't have time to do it or don't want to, and the nurses don't make them. The last thing you do in the morning should be to get a stack of washcloths and a basin of hot water on a tray table and go from room to room offering the wake up wash cloth to each of your residents.

fuzzywuzzy, CNA · May 6, 2010

A lot of the questions regarding individual residents' needs should be addressed in their care plans. You should also be able to ask another CNA. I would jot these things down at the beginning of your shift so you don't run into any surprises later (ie "oops that person was supposed to get a bath?").

It's normally facility policy to have 2 CNAs use a hoyer lift. If anyone at my workplace was caught using one by themselves they'd probably get fired.

Before breakfast if someone is sleeping and doesn't seem to thrilled about getting up I open up the blinds to let some light in, then go do someone else and come back in a little while. Normally people have to pee and/or be changed first thing in the morning so that kinda wakes them up anyway. If they don't want to eat you can't force them- it's not neglect if you make an effort to get them to eat and document this. Usually I leave the tray in there for a while and tell them to try and pick at it. If they still aren't eating I leave a drink and one small food item there and take the rest of the tray away. Sometimes they just didn't want to look at such a huge pile of food. You can always offer to get them something different too.

Where I work there isn't time to get everyone done up before breakfast. Some people get washed up and dressed before they eat but a lot just get toileted and eat in their PJs.

I find it hard to believe that you would be "done" with your residents and have nothing to do. There's always something to do- nail care, offer drinks, walk people, etc. although helping others is great. You'll have to ask if you're allowed to leave your hall though. If not I'm sure you guys have chores to do at the end of the day, like stocking the linen carts, or paperwork that you could get a head start on.

Ev1987 · May 6, 2010

Many of those questions regarding the patient could be answered by the nurse and other aides. Hoyers are for those who have limited mobility. I always have assistance when operating the hoyer. If the patient refuse to eat, that is their decision. I usually say "I'll leave this here for ten minutes, if you don't eat anything, I'll take it away." Most of the time, they snack on something. Record how much they eat in the charts. Try to find something to do, if your finished with the essentials. Trash, water and ice, gloves in all bathrooms and make sure residents are dry and/or comfortable in bed.

CoffeemateCNA · May 6, 2010

Yes, much of that information can be found in the residents' care plans. There are located at the nurse's station, and sometimes there are 3-ring binders with "CNA versions" in them.

Hoyer lifts are used for residents that are non-weightbearing, or for residents that are too large/heavy to be transferred safely by staff.

It's not ideal, but I wake residents up when it's time to eat and offer them their meal. If they don't want it, they can go back to sleep. My facility has no way of storing the food safely so that the resident can eat it at a later time.

If someone doesn't want to eat, I leave the tray there for a few minutes. They will usually pick at it and eat SOMETHING, even if they say they are not hungry. Just don't leave the food in there for too long, because microorganisms will quickly grow and make it unsafe to eat. Stupid staphylococcus and E. coli!! :)

It is quite rare that I get true free time. In the last year, I have taken maybe TWO 15-minute breaks total. Lunch/dinner breaks are all I can depend on. If I am not busy, I go offer my coworkers assistance. I know if I help them when they need it, they will return the favor when I need it.

You can certainly alert your management that oral care is not being given, but I guarantee you they already are aware of this. I have never worked at a facility in which oral care was consistently given. Unfortunately, it's one of the first things to get thrown under the bus when things get busy (which is pretty much ALWAYS). All you can really do is be a good example and provide oral care for your residents, hoping you will "rub off" on your coworkers.

Optimom · May 6, 2010

I had exactly same questions when I started at my current place as a brand new CNA. Nobody told me ANYTHING about patients, where supplies are, what is the procedure for lifts, and every little thing. I bugged fellow CNAs and figured them out. Of course some of them were not happy about me showering them bunch of questions because they are super busy, but that was all I had to do to provide a proper care to my patients and not to neglect them.

justme01 · May 7, 2010

I'm new too. This is my third week as a CNA and believe me when I tell you that I had all of the same questions. No one would give me any answers. I had to figure most of it out by watching the other aides and by asking the residents themselves.

You will quickly learn by observation and by trial and error what your residents can and cannot do for themselves. Transfers will become much easier when your residents learn to trust you. Not all residents transfer the same way. When you figure out how a particular resident transfers you can get in the routine of doing it the same way each time. When you both know what to do it will be quicker and easier.

Try waking the residents up for meals but if they are sleeping soundly you may not be able to rouse them. Go ahead and set the tray on the bedside table within their reach. You can pick it up when you pick up the other trays. Be careful about transferring a sleepy resident. They can easily fall out of the wheelchair.

Our residents have to be in nightgowns unless they have a special order saying that they are allowed to sleep in their daytime clothes. Look around the room in the drawers or closet. If the resident has their own nightgowns, put one on them. If not, use the facility's gown. If you do it wrong the nurse will let you know, and you will learn from your mistake.

I have not seen any residents receive proper oral care. A few take their teeth out at night. Many do not. Alot of residents are scared of having their teeth misplaced or stolen. If they don't brush themselves it doesn't get done. It's sad but true.

Residents require Hoyer lifts when they are too large to be safely lifted. Other residents need a Hoyer lift because they cannot bear any weight at all. Sometimes a resident will need a Hoyer temporarily when they have had a surgery or an injury. You are ALWAYS supposed to have two people when using a Hoyer. In reality many aides will shut the door and use the Hoyer alone. Some aides will do almost anything to avoid using the Hoyer because of the extra time it takes. I think that is ridiculous. There is a good reason why that resident should have a Hoyer.

When using the Hoyer, WATCH THE BAR. On my first day I saw two residents get hit on the head with the Hoyer bar. This should not happen. Watch the bar when hooking and unhooking.

rosey2007cna · May 9, 2010

I agree with having 2 people helping with a hoyer lift. The last place I worked at thought that I was crazy because I wanted to have an extra set of hands when I was using the hoyer. Of course they also told me that people did not need to be changed every two hours that they could wait until 3 hours :yawn: .

KimberlyRN89, BSN, RN · May 9, 2010

I agree with having 2 people helping with a hoyer lift. The last place I worked at thought that I was crazy because I wanted to have an extra set of hands when I was using the hoyer. Of course they also told me that people did not need to be changed every two hours that they could wait until 3 hours .

Maybe we worked at the same place !! This happened to me as well. 3 out of the 11 residents I had that weekend were hoyer lifts. The nurse on my hallway said "Make sure you have someone else with you when doing a hoyer". When it comes time to use the lift though, there is no one in sight!! I even asked the RN supervisor if he would just be in the room when I perform the hoyer lift & he said "no you can do it by yourself". :uhoh3: :uhoh3: Yet another reason why I quit that place..what a disaster!

tavia_yeung · May 13, 2010

Thank you so much all for answered all my questions:). Thanks again for the clear and great answers:yeah: :up: .

tavia_yeung · May 13, 2010

If you are talking about night shift especially, oral care is often never done in facilities. CNAs either don't have time to do it or don't want to, and the nurses don't make them. The last thing you do in the morning should be to get a stack of washcloths and a basin of hot water on a tray table and go from room to room offering the wake up wash cloth to each of your residents.

caliotter: When I'm on my 2 days training both was on the morning shift. The CNAs just woke them up and let the pt eat w/o any oral care at all:eek:. I questioned it in my head why wont they do that on the morning for the pts, so I asked my trainer "Do you want me to brush the pt teeth?" but she said just give them the food. I guess these CNAs are just too lazy then:rolleyes:. Of course I would always offer to do oral care for all my pts who cant do it by themselves, unless they refuse it.